Diagnostic Performance of Routine Abdominal MRI for Detecting Left Ventricular Hypertrophy in ADPKD

To evaluate the diagnostic performance of left ventricular (LV) volumetric parameters derived from routine abdominal MRI for detecting left ventricular hypertrophy (MRI-LVH) in patients with autosomal dominant polycystic kidney disease (ADPKD) who were previously diagnosed with LVH by echocardiography (Echo-LVH).

This retrospective study reviewed 156 ADPKD patients (27 with LVH). The LV wall (LVW) and cavity were manually segmented on T2-weighted abdominal MRI images to calculate 3 height-adjusted parameters: LV wall volume (ht-LVWV), LV cavity volume (ht-LVCV), and total LV volume (ht-LVV). Diagnostic performance was assessed using receiver operating characteristic curve analysis, with Echo-LVH as the reference standard. Subgroup analyses were performed across sex, chronic kidney disease stage, Mayo Imaging Classification, and blood pressure status. Sensitivity analysis was adjusted for body surface area, age, sex, and systolic blood pressure.

Ht-LVWV demonstrated high diagnostic accuracy for Echo-LVH, with an area under the curve (AUC) of 0.82 (95% CI: 0.74-0.90), sensitivity=92%, and specificity=64% at a threshold of 60 mL/m. Ht-LVV also showed good performance (AUC=0.70), while ht-LVCV had inadequate diagnostic performance (AUC=0.61). Ht-LVWV maintained robust performance across all clinical subgroups. After adjusting for confounders, the AUC for ht-LVWV improved to 0.92 (95% CI: 0.85-0.98).

Ht-LVWV measured on routine abdominal MRI is a promising biomarker for detecting LVH in ADPKD patients, with performance independent of key clinical variables. These findings support the potential for a diagnosis of MRI-LVH from standard ADPKD abdominal imaging protocols that are obtained routinely in the evaluation of ADPKD for renal and cardiovascular risk assessment in ADPKD.